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Are You Pee-Shy?

So, how does one come to find it difficult-or impossible-to urinate in the presence of others, whether the setting be a public facility or what had heretofore been the sanctuary of Home Sweet Home? The victims of "shy bladder syndrome" have a fear of leaving the house and being unable to find a "safe" toilet. They are thought by some to have an anxiety disorder, a type of social phobia, and yet it is rarely discussed by the sufferer. To paraphrase Lord Alfred Douglas, it is the fear that "dare not speak its name". Those who suffer from paruresis are quite literally remaining in the water closet: Many simply cannot urinate despite how uncomfortable they may be.

Shyness is nice, andShyness can stop youFrom doing all the things in lifeYou'd like to.........-----The Smiths

Aside from the suffering and embarrassment of having this "bashful bladder", a number of avoidance behaviors accompany paruresis that can be damaging to physical well-being: For example, sufferers might refrain from drinking fluids to avoid the use of a bathroom when away from home, risking dehydration, urinary tract infection and potential kidney damage.

I recall one patient of mine who complained of recurrent pain and pressure in the bladder while at work. He and I embarked on a urological work-up, measuring urinary retention and urine velocity, taking lab tests and undergoing advanced radiological evaluation, all of which were unrevealing. Finally, he explained to me his fear of urinating at the workplace, and any other public setting. His problem was a full bladder which he was only able to empty in the quietude of his home.

Is paruresis the result of our puritanical society? For males at least, is it a manifestation of castration or penis size anxiety, particularly when standing before that most intimidating of inventions, the wall-mounted urinal, shoulder to shoulder with a stranger? Is the relative dearth of public toilets in this country contributing to paruresis? I wonder whether the citizens of Nepal, where there are few private or public toilet facilities, experience pee-shyness.

A few large United States cities actually have the locations of their public restrooms available on websites, which might be superficially comforting to some. And of course there is SitOrSquat.com (and the iPhone app SitOrSquat), which can locate a toilet or restroom anywhere in the world. Still, it can be daunting to find a restroom in this country, particularly when many are restricted to "customers only". In contrast, in Italy for example, restaurants and bars are required by law to permit anyone-customer or no-to use the restroom.

Henry Miller wrote almost lovingly of the "pissoirs" in Paris, where the public was able to see all that went on at the lower part of those open air facilities; set among the throngs of the boulevards, it was more akin to a typical stall which we know to be hidden behind closed doors in this country. The urine of urination was nothing to be ashamed of. However, of New York City, Miller wrote, "I know that I am in distress when I walk the streets of New York. Wondering constantly where the next stop will be and if I can hold out that long". Sigmund Freud, upon his triumphant visit to New York, complained, "They escort you along miles of corridors and ultimately you are taken to the very basement where a marble palace awaits you, only just in time".

This country appears to have made relieving oneself a chore, and even something of which one is to be ashamed. It is with furtiveness we seek the restroom, and once there it is difficult to turn off that fight-or-flight attitude, for those with the shy bladder have such difficulty in letting their defenses down.

Aside from moving to Europe, what should be the therapeutic approach to paruresis? Cognitive-behavioral therapy appears to be the best option. There have been some reports of using gabapentin, atenolol and psychotropic drugs; but pharmacologic intervention has not been very effective, and in fact can contribute to urinary retention and difficulty emptying the bladder.

Perhaps 7% of the population of the United States is afflicted with paruresis. At least the paruresis patient can take comfort that he or she does not sit, squat or stand alone.

As someone who suffered from a severe case of shy bladder syndrome (Paruresis) for over 40 years, I can well attest to the deleterious effects this condition had on my life. Because I couldn't urinate in the presence of other people, I missed out on all kinds of life-affirming activities and opportunities. I had become a prisoner of My Own Private Bathroom, a sanctuary and source of salvation in my life, and I was desperate to be released from a life-long sentence.

That liberation came in the form of my discovery of the International Paruresis Association, a nonprofit organization that offers workshops and support services to help people recover from shy bladder. (http://www.paruresis.org).

Through exposure-based Cognitive-Behavioral Therapy (CBT), I made a full recovery to the extent that Paruresis no longer controls my life. My journey from being a severe paruretic to living a paruresis-free life led me to write a book, "Bathrooms Make Me Nervous" in the hope that my story will serve as an inspiration for others, especially women, who are similarly afflicted.

I have not beaten being pee shy but learned one of the problems that stopped me was the noise. The noise of others, the noise of myself that seems to become magnified. So if I go anywhere I take my MP3 player or smartphone and go into a stall wearing my headphones with the music cranked up so high that nothing but that music can be heard and I am able to go. Now, no way am I going to stand against a wall and piss with a bunch of guys standing next to me or even one guy standing next to me or even if anyone is in sight of me. But give me the handicapped stall and my MP3 player and I do stand a chance of going. So I thougfht I had a really good system till I got on a plane. The small confines of the toilet and the thought of a bunch of people waiting outside really threw me off. Now, even worse was the constant motion of the plane, the tight confines, and for me the glaring light. So now on the plane in the bathroom I wear sun glasses, have the MP3player cranked up,and It;s better if you can sit on the pot. Does;ent always work first time but I keep at it till I go. On the plane trip don;t drink anything unless you have to. Well hope this helps somebody or some people......

Many people think this is funny or that it is just the kind of feeling many people have in public toilets, but by someone who can't handle it, but it is a serious condition and shouldn't be made fun of.

Architects can fix this problem. Walk into any existing multi person restroom, count up the number of toilets and urinals in men's or toilets in women's and figure roughly an 8' X 5' single user restroom for each fixture. Compare this to the size of the multi person restroom with all of its circulation square footage (square footage for movement of multiple people within the restroom). Square footage savings can be as high as 50% by designing single user restrooms instead. See the web site.

I'm glad I didn't use this website in my research, as you clearly don't check facts. I'm "pee shy" but I certainly don't fear leaving the house or any of that other crap. I can whip my cock out easily enough in front of another guy - but the pee won't come out.

I have suffered for years but I can trace back to the EXACT incident that triggered mine. Ironically, it was a MOVIE that did me in. A movie from the late '70's starring James Brolin as a man who gets attacked from behind by two men while having his back to them while peeing at a urinal. They knock him out, mug him but when he comes to, he has been LOCKED inside the department store that he had been shopping in. The rest of the movie details his trying to escape the GUARD DOGS let loose to guard the store. THAT scenario left a LASTING impression on me and I am not comfortable peeing in public. We, as men are at our most vulnerable when our back is to the public, peeing. Once I realize that this film is the cause of my shy bladder, I can deal with it logically. Hope this helps someone else out there.

I'm 22 and I've had a shy bladder ever since I was about 5 or 6. I don't know why I have it, but for some reason, I feel like I just can't get over it. I can use a public bathroom just fine if I'm completely alone or if there's a lot of noise going on in the bathroom (faucets/hand dryers running, toilets flushing, screaming kids, etc.). But if I'm in a quiet bathroom with another woman, the urine just WON'T come out. I especially hate it when I'm in a public bathroom alone and someone walks in while I'm midstream. Whenever that happens I immediately stop urinating as soon as I hear the door open and I can't go again until that woman leaves, or until she flushes the toilet or washes her hands. I tell myself over and over again that everyone pees and everyone knows what it sounds like, but for some reason I still can't go. I've gotten bladder infections from involuntarily holding urine in public bathrooms. It sucks!

The reason why I hate school is me peeing. I have no luck everytime I use the restroom in class time there is still people in the restroom and I can't pee. I remember holding my pee for so long and when I went home, my bladder hurts so bad. Everytime I try to pee, even when I'm alone on the school restroom my heart starts pumping faster and my legs start shaking. Even when I'm in the stalls, I still can't pee. Can anyone please help me out? I know I can sit in the toilet and pee but I don't want those guys thinking I have a vagina.

My daughter also has this condition. She discovered a unique way to help her go while in a public restroom. She takes her Samsung galaxy or phone and plays a game. She said that there is no way to do both and she is then able to go. It certainly doesn't hurt to try. Hope this helps you.

I've had a shy bladder for almost 20 years now (and I am a woman). I didn't know there was a name for until just a few years ago, so I started looking up things about it online to see if I could find some helpful tips and advice. Nope! People always ignore the fact that women have this phobia too. And to rub salt into the wound, people always say that women's pee shyness is invalid and unjustified, and that we have no reason to feel embarrassed in public restrooms. News flash: THAT DOESN'T HELP AT ALL!!! Women have just as much of a reason to feel uncomfortable, embarrassed, and even nervous in public bathrooms as men, and I am beyond sick and tired of being told this phobia doesn't exist for women (uhh... I'm living proof that it does!) I'm sick of everyone ignoring us! This phobia has made my life a living hell and I have no one to turn to, because apparently I'm not allowed to even have this phobia just because I'm a woman! Apparently, pee shy women don't matter! Ugh!

Sorry, I just had to get that off my chest. It's really irritating, discouraging, and honestly extremely sexist how women with paruresis are always swept under the rug. We need help and support too.

It helps me to tell close friends about it, let them laugh a bit. Even though they can never know the pain and anxiety that comes with it. The airliner bathroom situation almost did me in last summer on a 6 hour flight. Told my wife that I wish to avoid long flights, but she wants to go to Europe soon. Not sure how I would survive that flight. Anyway, I don't have anxiety about penis size, that's ridiculous. My anxiety traces back to childhood when my Mom died. I've had problems ever since and not sure why. Now, work has become a problem at our new office with small public restroom and too many offices using it. Love to see the private stalls become the future in office design. I'm dealing with it somewhat, but still in pain from time to time. May God bless us all!